CHAPTER 15

Physical & Cognitive Development in Late

Adulthood

How Long Will How Long Will You Live?You Live?

• LongevityLongevityNumber of years a Number of years a person can expect person can expect to liveto liveDetermined by genetic Determined by genetic & environmental & environmental factorsfactors

• Average Life ExpectancyAverage Life ExpectancyAge at which half of Age at which half of the people born in a the people born in a particular year will particular year will have diedhave died

• Useful Life ExpectancyUseful Life ExpectancyNumber of years a Number of years a person is free from person is free from debilitating chronic debilitating chronic disease & impairmentdisease & impairment

• Maximum Life Maximum Life ExpectancyExpectancyThe oldest age to The oldest age to which any person liveswhich any person livesMaximum limit for Maximum limit for humans is around 120 humans is around 120 yearsyears

How Long How Long Will You Will You

Live?Live?• Genetic & Environmental FactorsGood way to increase life expectancy is to come from a family of long-lived individualsEnvironmental factors affect life spanEnvironment factors includeDiseases, toxins & pollutants, life style, social classMost environmental factors are caused by people

• Ethnic & Gender DifferencesWomen live longer than men in industrialized countriesMen being more susceptible to infectious diseases may be cause of shorter life spans or may be due to geneticsWomen have 2 X chromosomes & have a higher metabolic rate, higher testosterone levels

The 3rd-4th Age Distinction

• 3rd Age (Young 3rd Age (Young Old) “Good Old) “Good News”News”Increased life expectancy, with more older people living longer & aging successfullySubstantial potential for physical & mental fitness, with improvement in each generationEvidence of cognitive & emotional reserves in the aging mindHigh levels of emotional & personal well-beingEffective strategies to master the gains & losses of later life

• 4th Age (Oldest 4th Age (Oldest Old) “Bad Old) “Bad News”News”Sizable losses in cognitive potential & ability to learnIncreases in negative effects of chronic stressHigh prevalence of dementia (50% in people over 90), frailty, & multiple chronic conditionsProblems with quality of life & dying with dignity

Physical, Cognitive, &

Mental Issues •Demographics of Aging

Many changes due to increased over 60 yearsMany changes due to increased over 60 yearsMarketing will be targeted, have considerable Marketing will be targeted, have considerable political & economic powerpolitical & economic powerPressure on pensions, health care, & other Pressure on pensions, health care, & other servicesservicesDiversity of older adultsDiversity of older adultsOlder women outnumber older men in all ethnic Older women outnumber older men in all ethnic groupsgroupsOlder adults of the future will be better educatedOlder adults of the future will be better educatedBy 2030, 85% will have high school diploma & By 2030, 85% will have high school diploma & 75% will have college degree75% will have college degreeBetter educated tend to live longerBetter educated tend to live longerDue to higher incomes and better medical careDue to higher incomes and better medical care

Biological Biological Theories of Theories of AgingAging • Wear-&-tear

TheoryBody is like a machine that gradually deteriorates & finally wears outExplains some diseases (e.g. osteoarthritis)

Biological Biological Theories of Theories of

AgingAging• Cellular

TheoriesFocuses on processes that occur within individual cells which may lead to a build up of harmful substances or the deterioration of cells over a lifetimeTelomeres play a roleTips of the chromosomes

• Free Radicals Cause Cellular Damage that Impairs FunctioningChemicals produced randomly during normal cell metabolism, which bond easily to other substances inside cells

• CrosslinkingSome proteins interact randomly with certain body tissues, such as muscles & arteries stiffening the tissue

Biological Biological Theories of Theories of

AgingAging• Metabolic Metabolic

TheoriesTheoriesHigher caloric intake Higher caloric intake & stress lower life & stress lower life expectancy & expectancy & disease susceptibilitydisease susceptibility

• Programmed Programmed Cell Death Cell Death TheoriesTheoriesAging is genetically Aging is genetically programmedprogrammed

Changes in the Changes in the NeuronsNeurons

• Neurofibrillary TanglesNeurofibrillary TanglesFibers that compose the axon sometimes become twisted together forming a spiral-shaped mass

• Dendritic ChangesDendritic ChangesSome shrivel up & die making communications difficultOthers continue to grow

• Neuritic PlaquesNeuritic PlaquesDamaged & dying neurons sometimes collect around a core of protein producing the plaquesThese plaques interfere with normal functioning of healthy cells

The Aging Brain

How the How the Brain Brain ChangesChangesShrink & Slowing

Loses 5 to 10% of its weight between ages of 20 & 90

Dendritic losses & damage to myelin?

Adapting to Losses

Can repair itself

Aerobic exercise can increase brain volume

Sensory Changes

• 2 Major Kinds of Age-related Structural Changes in the Eye PresbyopiaDifficulty seeing close objects clearly, necessitating either longer arms or corrective lensesOther changes include cataractsOpaque spots on the lens that limit the amount of light transmittedGlaucomaImproper drainage of the fluid in the eye causing high pressure & loss of vision

Sensory Sensory ChangesChanges

• Changes in the RetinaMacular degeneration:Progressive & irreversible destruction of receptors from different causesDiabetic retinopathy:Involves fluid retention in the macula, detachment of the retina, hemorrhage, & aneurisms

Sensory Changes

• Hearing Loss Presbycusis:Cumulative effects of noise & normative age-related hearing problem causing reduced sensitivity to high-pitched tonesHearing loss is gradual at first but accelerates during the 40sResults from 4 types of changes in the inner ear

• Sensory: consisting of atrophy & degeneration of receptor cells

• Neural: consisting of a loss of neurons in the auditory pathway to the brain

• Metabolic: consisting of a diminished supply of nutrients to the cells in the receptor area

• Mechanical: consisting of atrophy & stiffening of the vibrating structures in the receptor area

Sensory Changes

• Taste, Smell, Touch, Temperature, Pain, & BalanceRemain largely in tactSmell declines after 70 for most peopleLarge declines are characteristic of Alzheimer’sChanges in balance make older people more likely to fall

CardiovasculCardiovascular Changesar Changes

• Heart Attack, Irregular Heartbeat, Heart Attack, Irregular Heartbeat, Stroke, Hypertension Increase Stroke, Hypertension Increase with Agewith AgeOverall death rated from these have been Overall death rated from these have been declining due to life style changesdeclining due to life style changesChanges that contribute to cardiovascular Changes that contribute to cardiovascular problems begin in young adulthoodproblems begin in young adulthoodFat deposits around the heart & in the Fat deposits around the heart & in the arteriesarteriesAmt. heart can pump per minute declines, Amt. heart can pump per minute declines, muscle tissue in the heart declines due to muscle tissue in the heart declines due to replacement by connective tissuereplacement by connective tissue

Cardiovascular Changes

• Strokes or Cerebral Vascular Strokes or Cerebral Vascular AccidentsAccidentsInterruptions in the blood flow to the brain due to blockage or hemorrhage in a cerebral arteryTransient ischemic attacks are early warning signs of strokeAn interruption in blood flow to the brainVascular dementiaNumerous small cerebral vascular accidentsCan have a sudden onset & may or may not progress gradually with varying symptoms

Cardiovascular Changes

• Chronic Obstructive Pulmonary DiseaseMost common form of Most common form of incapacitating incapacitating respiratory disease respiratory disease among older adultsamong older adultsCan result in depression, Can result in depression, anxiety, & need to be anxiety, & need to be continually connected to continually connected to oxygenoxygenEmphysema & asthma Emphysema & asthma are most common formsare most common forms

Health Health IssuesIssues

• SleepSleepOlder adults have more Older adults have more trouble sleepingtrouble sleepingTakes longer to fall asleep, get Takes longer to fall asleep, get less sleep, feel more negative less sleep, feel more negative effects after little sleepeffects after little sleepSome problems can be due to Some problems can be due to physical disorders, side effects physical disorders, side effects of medication, effects of of medication, effects of caffeine, nicotine, & stresscaffeine, nicotine, & stressSleep problems can disrupt Sleep problems can disrupt circadian rhythm circadian rhythm (sleep-wake (sleep-wake cycle)cycle)

• NutritionNutritionAs long as eating a well-As long as eating a well-balanced meal, don’t need balanced meal, don’t need supplementssupplementsMetabolism declines w/age Metabolism declines w/age causing body to not extract & causing body to not extract & use the nutrients the same use the nutrients the same wayway

• CancerCancerUnhealthy life-styles, genetics, Unhealthy life-styles, genetics, & exposure to cancer-causing & exposure to cancer-causing chemicals importantchemicals important

Cognitive Processes

• AttentionAttentionSelective attention: selection of relevant information & inhibition of irrelevant informationOlder adults tend to perform poorer on selective attention tasksWith practice, differences minimizedVigilance: sustained attention, involving the maintenance of attention over timeUncertain if vigilance declines

• Attentional Attentional ControlControlAbility to focus, switch, & divide attentionWith complex tasks, older perform poorer than youthDifference in attention depends on factors such as complexity, visual ability, & other cognitive factors

Cognitive Processes

• Psychomotor SpeedThe speed at which a person can make a specific responseRate at which cognitive processes slow varies greatly depending on the taskMost important reason reaction time slows is that older adults take longer to decide the need to respond, especially for ambiguous informationOlder adults who are physically fit show less slowing

MemoryMemory

• Poor Memory often Viewed as Poor Memory often Viewed as Inevitable with Age Inevitable with Age

• Working MemoryWorking MemoryGenerally declines with age

May be reason for age-related differences on tasks of cognitive performance

MemorMemoryy• Focus is Generally on 2 Types of Focus is Generally on 2 Types of

Memory ChangesMemory Changes• Explicit MemoryExplicit Memory

The deliberate & conscious remembering of The deliberate & conscious remembering of information that is learned & remembered at a information that is learned & remembered at a specific timespecific timeExplicit is divided intoExplicit is divided intoEpisodic memoryEpisodic memory: : having to do with the conscious having to do with the conscious recollection of information from a specific time or recollection of information from a specific time or eventeventSemantic memorySemantic memory: : concerning remembering concerning remembering meanings of words or concepts not tied to a meanings of words or concepts not tied to a specific time or eventspecific time or event

MemoryMemory• Implicit MemoryImplicit Memory

The unconscious remembering of information learned at some earlier timeOlder adults tend to perform worse on tests of episodic memoryTend to be less efficient at spontaneously using memory strategies to help their memoryOlder adults have problems in finding words and having more tip-of-the-tongue experiencesWith autobiographical memory, memories experienced between 10 & 30 more often reported than after 30

MemoryMemory• Widespread Belief

that Memory DeclinesWhat adults believe about their memories affects how well they performHow much effort put into trying to remember, how well predict performance, strategies used to remember

• Beliefs Related to Assumptions About the Degree Memory is Supposed to ChangePeople convince themselves the changes are worse than they areBeliefs influenced by changes in information processing (working memory)

Remediating Remediating Memory Memory

ProblemsProblems • Program for Program for

Memory AidsMemory Aids• External AidsExternal Aids

Memory aids that rely on environmental sources such as notebooks or calendars

• Internal AidsInternal AidsMemory aids that rely on mental processes such as imagery

• Explicit-internal Explicit-internal AidsAidsRehearsal to remember a phone number

• Explicit-externalExplicit-externalTaking notes during a doctor’s visit

• Implicit-internalImplicit-internalAssociating the color of an indoor parking structure

• Implicit-externalImplicit-externalVisualizing images that represent time of day and number of pills to be taken

Abnormal Memory Change

• Does Memory Problem Interfere with Daily Life?Loss of memory of spouse’s name, etc., get an examinationComplete physical & neurological with battery of psychological to identify the nature of the problemTake the necessary steps to alleviate the difficulties

Creativity & Creativity & WisdomWisdom

• CreativityCreativityThe ability to The ability to produce work that is produce work that is novel, high in novel, high in demand, & task demand, & task appropriateappropriateHighest creativity Highest creativity during 20s, plateaus during 20s, plateaus in 30s, & declines in 30s, & declines afterafterCreative people Creative people continue to produce continue to produce creative ideas, but creative ideas, but fewer after 30sfewer after 30s

• WisdomWisdomSeen from 3 main Seen from 3 main perspectivesperspectives1. The orchestration of 1. The orchestration of mind & virtue, mind & virtue, involving the ability to involving the ability to solve difficult real-solve difficult real-world problemsworld problems2. Postformal thinking2. Postformal thinking3. Action-oriented 3. Action-oriented knowledge acquired knowledge acquired w/out direct help form w/out direct help form others that enables others that enables people to achieve people to achieve goals they valuegoals they value

4 Characteristics of 4 Characteristics of WisdomWisdom

• Wisdom deals with important or Wisdom deals with important or difficult matters of life & the human difficult matters of life & the human conditioncondition

• Wisdom is superior knowledge, judgment, Wisdom is superior knowledge, judgment, & advice& advice

• Wisdom is knowledge with extraordinary Wisdom is knowledge with extraordinary scope, depth, & balance, applicable to scope, depth, & balance, applicable to specific situationsspecific situations

• Wisdom, when used, is well intended & Wisdom, when used, is well intended & combines mind & virtuecombines mind & virtue

WisdoWisdomm• A Wise Person:

Is able to Integrate Thinking, Feeling, & Acting into a Coherent Approach to a ProblemEmpathy & compassion are important characteristicsThey are able to overcome automatic responses & see through situations getting to the heart of the matter than being caught in the details

• 3 Factors to Wisdom1. General Personal ConditionsMental ability2. Specific Expertise ConditionsMentoring or practice3. Facilitative Life ContextsEducation or leadership experience

Mental Health & Intervention

• DepressionDiagnosing depressionDiagnosing depressionMost common symptom is feeling Most common symptom is feeling sad or downsad or down

• DysphoriaOlder adults express this as Older adults express this as “feeling helpless” or “feeling “feeling helpless” or “feeling tired”tired”Apathy & expressionless Apathy & expressionless confining themselves to the bed, confining themselves to the bed, self neglect, & making self neglect, & making derogatory statements re: selfderogatory statements re: selfLoss of appetite, insomnia, & Loss of appetite, insomnia, & trouble breathingtrouble breathing

• CausesImbalances of specific Imbalances of specific neurotransmittersneurotransmittersPsychosocial factors such as loss Psychosocial factors such as loss & internal beliefs systems& internal beliefs systemsLoss of a spouse, a job, good Loss of a spouse, a job, good health, etc.health, etc.Internal belief systemsInternal belief systemsWhat one tells oneself about why What one tells oneself about why certain things are happeningcertain things are happeningBelief of being personally Belief of being personally responsible for all the bad things responsible for all the bad things that happen to them, things are that happen to them, things are not going to get any better, life is not going to get any better, life is a messa mess

Mental Health &

Intervention• TreatmentTreatmentSevere cases medications for the balance of Severe cases medications for the balance of neurotransmittersneurotransmittersHeterocyclic antidepressants, monoamine oxidase Heterocyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitorsinhibitors, selective serotonin reuptake inhibitorsBehavior therapyBehavior therapyDepressed people receive too few rewards from Depressed people receive too few rewards from their environmenttheir environmentIncrease the good things that happen & minimize Increase the good things that happen & minimize the negativethe negativeCognitive therapyCognitive therapyMaladaptive beliefs or thoughts about oneself are Maladaptive beliefs or thoughts about oneself are responsible for the depressionresponsible for the depressionDepression is treatableDepression is treatable

Anxiety Anxiety DisordersDisorders

• Behavioral and Psychological ProblemsBehavioral and Psychological ProblemsFeelings of severe nervousness for no Feelings of severe nervousness for no apparent reason, phobias, obsessive-apparent reason, phobias, obsessive-compulsive disorders, thoughts or actions compulsive disorders, thoughts or actions that are repeatedly performedthat are repeatedly performedMore common in older adults due to loss of More common in older adults due to loss of health, relocation stress, isolation, fear of health, relocation stress, isolation, fear of losing independence, etc.losing independence, etc.Can be treated with medication & Can be treated with medication & psychotherapypsychotherapyRelaxation therapy is highly effective & Relaxation therapy is highly effective & easily learnedeasily learned

Alzheimer’sAlzheimer’s• Disease Involving Serious

Impairment of Behavioral & Cognitive FunctioningSymptoms:Gradual decline in memory, learning, attention, & judgmentConfusion as to time & placeDifficulties in communicating & finding the right wordsDecline in personal hygiene & self-care skillsInappropriate social behaviorPersonality changesIn advanced stages, incontinence

Diagnosing Diagnosing Alzheimer’sAlzheimer’s • Accuracy

Depends on a thorough series of medical & psychological tests, including blood tests, metabolic & neurological tests, & neuropsychological testsInterview of family necessaryOften inaccurate in assessment

• Much Attention Focused on Protein Beta-amyloidProtein that is produced in extremely high levels in Alzheimer’s possibly causing the plaques & tangles

• CausesSome forms are inheritedChromosomes 12, 14, 19, 21Treatment:Symptoms can be alleviated with medicationAcetylcholinestrase inhibitors

Parkinson’s Disease • Known for its

Characteristic Motor SymptomsVery slow walking, difficulty getting into & out of chairs, & a slow hand tremor

Effectively treated with L-dopa which raises the functional level of dopamine in the brain